What is whooping cough?

Whooping cough, also known as pertussis, is a bacterial infection that inflames the lungs and airways. The pertussis bacteria also infect the windpipe, where they bring on a persistent, violent cough.

The name comes from the weird birdlike "whooping" sounds that children who have the illness typically make when they try to take a deep breath between coughs. (Babies may not be strong enough to make this characteristic whooping sound.)

What are the symptoms?

Whooping cough often starts with cold or flulike symptoms – sneezing, runny nose, and a mild cough, which may last up to two weeks before the more severe coughing spells begin. Your child may also have a fever.

A child with whooping cough will typically cough for 20 or 30 seconds nonstop and then struggle to breathe before the next coughing spell starts. During coughing episodes, which seem to happen more often at night, your child's lips and nails may turn bluish from lack of oxygen. She may cough up or vomit a thick mucus.

Special dangers for babies

This illness can be very dangerous for babies under a year old, who are especially susceptible to complications such as pneumonia, convulsions, brain damage, and even death. If you think your baby may have whooping cough, it's important to take her to the doctor right away.

It's also important to watch babies with pertussis closely in case they stop breathing. If your baby has any trouble breathing, call 911 or take her to the nearest emergency room. Also take her to the ER if she has persistent vomiting, seizures, or signs of dehydration.

How did my child get this disease?

Whooping cough is very contagious. Your child could have gotten it from direct contact with someone infected with the bacteria or by simply breathing air infected with the germs. The bacteria usually enter the nose or throat.

Most children receive several vaccinations against whooping cough (pertussis) as part of the DTaP series, which also protects against diphtheria and tetanus. The shots start at 2 months of age and continue until the child is 4 to 6 years old.

Your child's protection against the disease increases with each shot she receives, so her risk of getting it will be at its lowest after she receives the fifth shot of the series, between 4 and 6 years of age. Even then she has a small chance of coming down with whooping cough, because the vaccine isn't 100 percent effective.

The number of cases in the United States rose from about 1,000 in 1976 to almost 26,000 in 2005. (The number has declined somewhat since then.) Most of these infections were in babies younger than 6 months and children over age 7.

The Centers for Disease Control and Prevention (CDC) has warned that, as a precaution, young babies should be kept away from anyone with a cough. They also recommend that adults and adolescents in contact with babies receive a dose of the Tdap vaccine to protect them from contracting whooping cough and transmitting it to babies.

What will the doctor do?

The doctor will listen to your child's cough, and perhaps swab her nose to test the cells for the pertussis bacteria. If the doctor suspects that your child has whooping cough, he won't wait for test results, though, as these can take some time. He'll go ahead and give her an antibiotic to fight the infection right away. (Once a diagnosis of whooping cough is confirmed, all of the child's close contacts will need to be treated with antibiotics as well.)

Antibiotics can help relieve symptoms if given very early on. If given later, they may not shorten the course of the illness, but they can still remove the bacteria from your child's secretions, preventing her from spreading the infection to others. Beyond that, you can't do much other than wait for the cough to subside, which typically takes six to ten weeks.

Don't give your child a cough suppressant unless your doctor recommends it. Coughing is what the body naturally does when it needs to clear the lungs of mucus. If you suppress that reaction, you may be hindering your child's ability to heal.

Of course, if the cough gets worse even with antibiotics, call your doctor immediately. In serious cases, children have to be hospitalized, put on oxygen, and given intravenous fluids to avoid dehydration.

After having whooping cough, is my child immune or does she need to get the rest of her pertussis shots?

Unfortunately, it's possible for someone who's had whooping cough to get it again, although any later infection is usually much milder than the first. So because your child is still susceptible to the illness – and because the DTaP shot contains important protection against diphtheria and tetanus as well – make sure she finishes the series.

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